Open Enrollment is almost here, and it’s time to make sure you’re choosing the right health plan for 2024. Whether you’re switching to a new provider or adjusting your existing coverage, there are a few critical areas to focus on. Let’s explore!

Understanding Open Enrollment

Open Enrollment, which runs from November 1, 2023, to January 15, 2024, is your annual window to make changes to your health insurance plan. During this period, you can switch plans, enroll in new coverage, or make adjustments to meet your changing healthcare needs. Missing this window could leave you stuck with a plan that doesn’t fully meet your requirements for another year. That’s why it’s so important to get everything right.

Why Switching Health Plans Can Be a Smart Move

You might be satisfied with your current plan, but if your healthcare needs have changed—such as a new medical condition or an upcoming surgery—it’s worth reviewing your options. Switching plans during Open Enrollment can help you:

• Ensure you’re covered for new or anticipated health needs
• Potentially lower your premiums or out-of-pocket costs
• Take advantage of new benefits or provider networks

If you’ve been considering switching, now’s the perfect time to dive into the details! 

Key Considerations for DME (Durable Medical Equipment)

One critical area that often gets overlooked during Open Enrollment is Durable Medical Equipment (DME) coverage. If you or a family member rely on items like catheters, diabetic supplies, wheelchairs, or CPAP machines, ensuring that your new plan covers these is essential. 

Here’s what to check for:

• List of covered DME items: Plans vary in what they cover, so make sure the equipment you need is included. Plans also vary in how much they cover, call us today to see if your current supplies or the supplies you want will be covered. 
• Rental vs. purchase options: Some plans may only cover rentals, not purchases, which can affect long-term costs.
• Suppliers in-network: Make sure you can get your equipment from a provider that’s in your plan’s network. If you are switching call us to ensure we are in network and that your supplies will be covered under your new plan. 

Ensuring Coverage for Special Care Needs

If you or a family member have ongoing special care needs, such as physical therapy, mental health support, or chronic illness management, you’ll need to ensure these services are covered under the new plan. 

Be sure to ask about:

• Referrals: Does the plan require them for specialist visits?
• Limits on visits: Some plans restrict the number of specialist or therapy sessions per year.
• Copays and coinsurance: Know what you’ll pay out of pocket for these specialized services.

How Pregnancy Coverage Might Vary by Plan

Pregnancy is a major life event, and the healthcare associated with it can be costly without the right coverage. If you’re planning a pregnancy or are currently pregnant, make sure your new health plan includes comprehensive maternity care. 

Some things to confirm include:

• Prenatal visits and ultrasounds: Are they fully covered, or will you have copays?
• Hospital delivery costs: What percentage of your labor and delivery will be covered?
• Postnatal care for baby and mom: Ensure newborn care is included in the coverage.

Importance of Weight Loss and Wellness Program Benefits

If managing your weight or participating in wellness programs is a part of your healthcare routine, don’t forget to check whether your new plan offers these benefits. Some plans provide discounts or full coverage for weight loss programs, nutrition counseling, and even gym memberships. 

Be on the lookout for:

• Coverage for dietitian visits: Especially important if you're dealing with conditions like diabetes or high blood pressure.
• Weight loss surgeries: If you’re considering bariatric surgery, make sure your plan covers the procedure and follow-up care.

Questions to Ask When Evaluating New Plans

As you narrow down your options, ask these key questions to ensure you’re picking the right plan:

• Are my preferred doctors and specialists in-network?
• What’s the deductible, and how does it apply to various types of care (e.g., prescriptions vs. hospital visits)?
• Does the plan cover emergency care out-of-network?
• What is the annual out-of-pocket maximum?
• Are the DME supplies I need going to be covered under the plan? 
• Is my preferred supplier in network?
• Are prescription medications I take regularly covered under the plan’s formulary?

Navigating the Enrollment Process Online

The good news is that switching plans or adjusting your coverage is easier than ever. You can visit healthcare.gov to review plan options, compare benefits, and sign up—all from the comfort of your home. Be sure to have your personal information, including your current coverage details, income information, and household size, handy to make the process smooth.

Helpful Resources and Links to Explore

Here are some additional links that can help guide you through Open Enrollment 2024:

Open Enrollment FAQ

Understanding DME Coverage 

Healthcare Cost Estimator  

Open Enrollment 2024 is the ideal time to ensure your healthcare plan meets your needs, whether you require DME coverage, are planning for pregnancy, or simply want to explore wellness programs. Don’t let this window pass without making sure your plan covers what matters most to you and your family.

Call us at 800-503-7604 to ensure we will be in network with your new plan and that your supplies will remain within reimbursement.